Abreva before and after


What are cold sores?

Cold sores, also known as fever blisters, are small, fluid-filled blisters that crop up on or near the lips.

They can appear individually or in clusters. Despite their name, cold sores have nothing to do with colds.

Some people confuse cold sores with canker sores. Canker sores are crater-like sores that usually appear individually on the tongue or gums or on the inside of the cheeks.

Courtesy of the CDC

What causes cold sores?

Cold sores are caused by the herpes simplex virus. Herpes simplex virus type 1 usually causes cold sores, and herpes simplex virus type 2 usually causes genital herpes, though either can cause sores in the facial or genital area.

How did my child get the virus?

Someone with the virus – most likely in the form of a cold sore or herpes gingivostomatitis – gave it to him. Most people who get the herpes simplex virus get it sometime during childhood.

For example, maybe your child shared a cup, utensil, or slobbery toy with someone who has the infection. Or maybe he was kissed by someone with the virus in her saliva (whether or not the person had a visible sore).

Babies can also get the herpes virus during a vaginal birth if their mother has genital herpes. You can’t transmit the virus to your baby by breastfeeding, though, even if you have an active cold sore.

Are there other symptoms?

During the first bout with the herpes simplex virus – called primary herpes – your child may have mouth soreness (the blisters can spread throughout the mouth during this first episode), gum inflammation, and perhaps a fever, swollen lymph nodes, and a sore throat. These primary symptoms may be very mild, and you may not even notice them.

Your child will get better in about 10 to 14 days, but the virus will stay in her body for life. In some people, the virus lies dormant and never acts up. In others, it periodically flares up and triggers cold sores.

These flare-ups are called secondary herpes. Stress, fever, and sun exposure – but not contact with a cold sore – seem to trigger outbreaks.

During these secondary flare-ups, your child probably won’t have swelling of her gums or lymph nodes or a fever or sore throat, but she will have the telltale blistering on or near her lips.

Are cold sores ever dangerous?

Cold sores themselves aren’t dangerous, but it is possible for the virus to spread to other parts of the body – and that can be dangerous.

It’s very unusual for a child to get a cold sore in the first six months or so of life, because the antibodies received from his mother offer some protection. But if your baby is younger than 3 months old and he gets any kind of mouth sore, call his doctor right away. In young babies, in particular, the herpes virus can spread to the brain and other organs, causing serious, potentially permanent or fatal damage.

Try to keep your child from touching his eyes when he has a cold sore. When the virus spreads to the eyes, it’s called ocular herpes. This is a serious eye infection.

If your child develops a sore on his eyelid or the surface of his eye, call the doctor right away. Your child may need antiviral drugs to keep the infection from scarring his cornea. In rare cases, ocular herpes can weaken vision and even cause blindness.

What’s the best way to treat a cold sore?

A cold sore will go away on its own. Here are some ways to ease any discomfort:

  • Apply ice (or a cool, wet cloth) to the sore, to help with redness and swelling.
  • Give your child the proper dose of a mild pain reliever, such as acetaminophen or (if she’s 6 months or older) ibuprofen. (If your child is younger than 3 months old, call the doctor before giving her any medication. And never give aspirin to a baby. It could trigger Reye’s syndrome, a rare but life-threatening illness.)
  • Avoid citrus fruit and other acidic food (such as tomatoes) that might make the sore hurt more.
  • Try over-the-counter ointments to relieve the pain and help heal the cold sore. (If your child is younger than 12 months, check the age recommendations on the package and talk with the doctor about what’s best for your child.)
  • If the sore is severe, the doctor may prescribe an antiviral topical or oral medicine.

If your child’s cold sore is painful, it may interfere with eating. If that’s the case, talk with her doctor right away.

How can I prevent cold sores and keep them from spreading?

One peck with an infected lip is all it takes to pass on the virus.

If you have a cold sore:

  • Avoid kissing your child, especially if he’s a newborn, until the cold sore goes away. If your child is an infant, consider wearing a surgical mask to cover the sore as well.
  • Avoid sharing cups and eating utensils.

If your child has a cold sore:

  • Wash his hands regularly.
  • Try to keep him from picking at the cold sore. (Try putting mittens or socks on his hands while he sleeps.)
  • Don’t let him share toys.
  • Don’t let him share drinks or eating utensils.
  • Don’t let him kiss babies.

Exposure to sunlight can trigger an outbreak once a child has the virus. So if your child seems prone to cold sores as he gets older, sun protection is a particularly good idea. A hat with a brim and some lip balm for protection should help.

Generic Name: Docosanol (doe KOE san ole)
Brand Name: Abreva

Medically reviewed by Drugs.com. Last updated on Apr 27, 2019.

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Uses of Abreva:

  • It is used to treat cold sores.

What do I need to tell my doctor BEFORE I take Abreva?

  • If you have an allergy to docosanol or any other part of Abreva (docosanol).
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

This medicine may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Abreva (docosanol) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Abreva?

  • Tell all of your health care providers that you take Abreva (docosanol). This includes your doctors, nurses, pharmacists, and dentists.
  • Talk with your doctor before you use other drugs or products on your skin.
  • This medicine may cause harm if swallowed. If Abreva (docosanol) is swallowed, call a doctor or poison control center right away.
  • Do not give Abreva (docosanol) to a child younger than 12 years old without first checking with the doctor.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using Abreva (docosanol) while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

How is this medicine (Abreva) best taken?

Use Abreva (docosanol) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • Keep using Abreva (docosanol) as you have been told by your doctor or other health care provider, even if you feel well.
  • Do not take Abreva (docosanol) by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).
  • Use at the first sign of a cold sore.
  • Wash your hands before and after use.
  • Put on affected part and rub gently.
  • Makeup may be used after the skin has dried.
  • Do not rub the cold sore. Rubbing the cold sore may make it worse. It may also cause the cold sore to spread to other areas around the mouth.

What do I do if I miss a dose?

  • Put on a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not put on 2 doses or extra doses.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Very bad irritation where Abreva (docosanol) is used.

What are some other side effects of Abreva?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if you have any side effects that bother you or do not go away.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Abreva?

  • Store at room temperature. Do not freeze.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer information use

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about Abreva (docosanol), please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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  • Drug class: topical anti-infectives

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Professional resources

  • Abreva (AHFS Monograph)

Related treatment guides

  • Herpes Simplex

Cold Sores in Toddlers

What are cold sores?

Cold sores, also known as fever blisters, are small red blisters that crop up near the lips or on them. More rarely, they sprout on the roof of the mouth. (Some people confuse them with canker sores, which are painful crater-like sores that appear on the tongue or on the inside of the cheeks.) Despite their name, cold sores actually have nothing to do with colds; they’re caused by the herpes simplex virus type 1 (HSV-1), a close relative of the virus that causes genital herpes. How do you get cold sores? Most children pick up the virus by sharing food with or kissing someone who has a cold sore. They can also get the infection from someone who doesn’t have a visible sore but has the virus in his or her saliva. Once you contract the virus, it stays in your body for good, hiding in nerve cells near your ear. In some people, the virus lies dormant and never causes harm. In others, it periodically wakes up and triggers cold sores. Nobody knows what stirs the virus into action, but stress, fever, colds, and sunburn seem to encourage outbreaks. What are the symptoms? Children don’t develop cold sores immediately after the first time they catch the virus. Instead, your child may have swollen gums and a sore feeling in the mouth. A few days later, you may see a cluster of small blisters that turn into a shallow, painful sore, possibly accompanied by fever and swollen lymph glands in the neck. In a few days the sore will crust over and slowly disappear. The whole flare-up lasts about seven to ten days. What’s the best way to treat cold sores? Cold sores will go away on their own, but there are some things you can do to help your child feel better in the meantime. •To ease the pain, apply ice to the sore or give your child a mild pain reliever, such as ibuprofen or acetaminophen. (Never give aspirin to children or teenagers; it may trigger Reye’s syndrome, a rare but potentially life-threatening illness.) •Have your child avoid salty, spicy, and sour foods, which irritate the raw nerves in the sore. •Dab on a water-based zinc ointment. It helps dry out the sore so it can heal faster, and the zinc may also aid the immune system. To keep your child from infecting other parts of his body or giving the virus to someone else, encourage him to wash his hands regularly and keep him from picking at his sores. One last caution: Urge your child to avoid touching his eyes when he has a cold sore. HSV-1 can cause ocular herpes, a serious eye infection. If your child develops a painful sore on his eyelid or the surface of his eye, schedule a prompt appointment with his pediatrician: Your child may need antiviral drugs to keep the infection from scarring his cornea. In rare cases, ocular herpes can weaken vision and even cause blindness. Also, any kind of herpes virus is dangerous to newborns. If you have a newborn, keep any of your children who have a cold sore away from him until it’s healed. How can I prevent cold sores? The first thing you can do is try to keep your child free of the virus that causes cold sores, which may be difficult, given how contagious HSV-1 is. Remember, one peck with an infected lip is all it takes to pass on the virus. If you have sores and your child doesn’t, cut out kissing until you’ve healed. If you are the parent of a newborn and have a cold sore, you don’t need to separate yourself from your new baby. Do wash your hands frequently, though, and avoid kissing your baby until the cold sore goes away. You may consider wearing a surgical mask to cover the sore as well. Infectious disease experts do recommend that women with herpes sores on their breasts refrain from breast feeding until the sores are healed. If your child already has the virus, the best thing you can do is keep his immune system strong by making sure he gets a healthful diet, plenty of sleep, and regular exercise. Giving your child a daily multivitamin may also help boost his immune system. You should protect your child from the sun as well. If he ventures outside on a sunny day, slather him with sunscreen and put on a lip balm that contains sunblock.

Cold sore is a contagious illness caused by a viral inflammation (Herpes simplex). The illness appears as stinging blisters and painful wounds in the mouth and on the lips. The illness has a tendency to return again and again – often simultaneous with a severe common cold. Call the doctor immediately, if the cold sores spread to the nose or the eyes.

Cold sore is a contagious illness caused by a viral inflammation (Herpes simplex). Often, the illness starts with redness and an unpleasant prickly sensation in the skin where the blisters appear later. After a few days, small blisters filled with fluid develop which quickly bursts and become sores. The sores are covered by a crust that typically falls off after 8 to 10 days. The blisters and the sores are placed on the lips and inside the mouth.

The worst part about cold sores is that they have a tendency to return again and again. When you have had your first outbreak of cold sores, there is always a risk that they might return. Typically, they return in connection with a common cold (hence the name cold sores) or another infection. Also sunlight can make the sores return. One in every 5 people has repeated outbreaks of cold sores throughout their lives.

All children can become infected with the illness but most children have their first outbreak of cold sores, when they are 3 to 5 years old. It is expected that 80% of all adults have had cold sores, at some point in their life.

With the smallest children (1 to 3 years), the illness appears as an inflammation of the oral cavity. Inside the mouth, on the inside of the cheeks and gums, the mucous membrane appears red and covered with blisters. It is common that the child, at the same time, has a light fever.

Interview Transcript

Dr. Gellner: Cold sores are something adults get pretty often, but what should you do if your child has one? I’ll tell you how to help them out on The Scope. I’m Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering the healthy kid zone with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Pretty much every adult has had a cold sore at least once in their lifetime, and 20% of us have had recurring cold sores. They come back all the time because of fevers, stress, even sunburns and being exhausted. All of those things take a toll on our immune systems, and the herpes simplex virus takes that opportunity to pop out a lovely cold sore.

Cold sores usually happen for the first time after your child has had contact with somebody with herpes. Now, don’t worry. It’s not that kind of herpes that causes cold sores. Once infected, the virus lives quietly in the body unless it’s triggered by something, and then another crop of blisters shows up.

Cold sores only happen on one side of the mouth and appear in a cluster. So if your child has a different rash around their mouth, it’s probably not a cold sore. Just before a cold sore shows up, your child might have a tingling or burning feeling on the outer lip, and it’s usually in the same place that cold sores have been before.

The blisters normally burst, scab over, and dry up, causing the honey-crusted appearance we all know. After the sores dry up, they aren’t as contagious anymore. The whole blister dry-up process takes up to two weeks. So if your child gets a cold sore, what can you do?

Well, ice helps a lot. Putting ice on the area that is tingling can actually stop the infection from progressing and being a full-fledged breakout. There are several cold sore ointments available over the counter to try, too. You can put them on your child as soon as the small bumps appear to help decrease the outbreak severity. Petroleum jelly can help as well.

Cold sores are contagious while they are in blister form. It’s the fluid inside the blisters that has the virus. This is important to know so that you can take precautions during the most infectious time of the breakout. While cold sores are painful, annoying, and unsightly, they are quite common. Tylenol and Motrin can help the pain. If your child gets them repeatedly, ask your doctor if they’re old enough for anti-herpes pills. There are a few kinds, but they aren’t safe for all kids and they do require a prescription.

If any sores show up by your child’s eye, that’s a true medical emergency and they need to get on this medication as soon as possible.

Announcer: Want The Scope delivered straight to your inbox? Enter your email address at thescoperadio.com and click “Sign me up” for of our latest episodes. The Scope Radio is a production of University of Utah Health Sciences.

When Your Child Has Cold Sores

Cold sores (also called fever blisters) are a common problem in children. They usually appear outside the mouth. Cold sores often begin as 1 or a cluster of blisters, which then crust or scab over. They can spread through direct contact. If your child has cold sores, it’s important to teach him or her how to keep from spreading them to others.

  • Cold sores are caused by the herpes simplex virus (HSV). There are 2 types of this virus. The type that usually affects the mouth is called HSV1. It’s very common in children.

  • HSV stays in the body once your child has it. Cold sores can appear randomly or when something triggers them. Triggers can include:

    • An injury to the mouth

    • Fever or illness

    • Stress

    • Sun exposure

    • Lack of sleep

    • Friction or rubbing mouth

What are the symptoms of cold sores?

Symptoms can include tingling, burning, or itching felt in the affected area a few days before the appearance of sores. The sores themselves can cause burning, stinging, or itching. The sores are often blister-like and red at first. They then dry out and scab over. Cold sores may last 10 to 14 days.

How are cold sores spread?

Cold sores can be spread in the following ways:

  • Direct contact with the sores (like through touching or kissing)

  • Contact with items (like cups, toothbrushes, or towels) that have been contaminated by an infected person

How are cold sores diagnosed?

Cold sores are diagnosed by how they look. To get more information, the health care provider will ask about your child’s symptoms and health history. The health care provider will also examine your child. You will be told if any tests are needed. A skin biopsy or viral culture can also be performed.

How are cold sores treated?

  • Cold sores generally go away within 10 to 14 days with no treatment.

  • If your child has a sensation that a cold sore may be coming on, applying an ice cube or pack for 20 minutes may prevent it.

  • Ask the health care provider if there are any prescriptions or over-the-counter (OTC) medicines that will help your child feel better, faster. Topical or oral antiviral medicine can be prescribed if your child has recurrent cold sores. To be effective, the medicine needs to be taken as soon as symptoms appear.

  • You can do the following at home to relieve cold sore symptoms:

    • Make sure your child gets plenty of rest.

    • Give your child OTC medicines, like ibuprofen or acetaminophen, to treat pain and fever. Do not give ibuprofen to an infant less than 6 months of age, or to a child who is dehydrated or constantly vomiting. Do not give aspirin to a child with a fever. This can put your child at risk of a serious illness called Reye syndrome.

    • Cold liquids, ice, or frozen juice bars may help soothe mouth pain. Avoid giving your child spicy or acidic foods.

  • Use the following treatments only if your child is over the age of 4:

    • Apply an OTC numbing gel to mouth sores to relieve pain. The gel can cause a brief sting when applied.

    • Have your child rinse his or her mouth with saltwater or with baking soda and warm water, then spit. The mouth rinse should not be swallowed.

When to call the healthcare provider

Contact the healthcare provider if your child has any of the following:

  • A cold sore that doesn’t go away within 14 days

  • Cold sores that come back frequently

  • A cold sore that grows larger or appears near the eyes

  • Increased mouth pain

  • Trouble swallowing

  • Signs of infection around a cold sore (pus, drainage, or swelling)

  • Signs of dehydration (very dark or little urine, excessive thirst, dry mouth, dizziness)

  • Your child has a fever (see fever section below)

  • Your baby is fussy or cries and cannot be soothed.

  • Your child has had a seizure caused by the fever

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

How is the spread of cold sores prevented?

Follow these steps to keep your child from passing cold sores on to others:

  • Teach your child to wash his or her hands with soap and warm water often. Handwashing is especially important before eating or handling food, after using the bathroom, and after touching the sores.

  • Do not allow your child to share cups, utensils, napkins, or personal items, like towels and toothbrushes with others.

  • Keep your child from kissing others when he or she has a cold sore.

  • Keep your child’s hands out of his or her mouth. Encourage your child to not touch his or her face with his or her hands.

  • Wash any toys or items that your child places in his or her mouth.

  • Use lip balm with sun protection


Thank you for puchas ing ABREVA . We hope that since ABREVA shortens the healing time of cold sores, it helps you look and feel better faster. Please follow insert directions for proper use and
refer to the information below.

You are not alone

An estimated one-in-five Americans is affected by cold sores each year. Most people who experience them get two to three cold sore outbreaks each year. Just before and during an outbreak, the cold sore
infection can be easily passed on to others. It is especially important to be aware of early warning sign that a cold sore is coming, and to be sure to avoid close physical contact when you have one.

Getting to the Root of the Problem

A blister, or cluster of blisters around your mouth, is caused by the cold sore virus. After the cold sore has healed, the virus stays dormant in your body but can be reactivated by everyday triggers like stress,
sunlight, extreme hot or cold weather, colds and flu, lack of sleep, or menstruation.

The Sooner, the Better

A typical cold sore outbreak can last as long as seven to ten days. The sooner you begin using ABREVA, the more effective the medicine will be. So for best results, use ABREVA at the very start
of the cold sore – when you feel the first sign of the tingle, redness, bump or itch.

ABREVA is different from other over-the-counter cold sore products. Only ABREVA contains 10% docosanol, which helps to shorten the healing time of cold sores and the duration of symptoms
including tingling, pain, itching and burning.

Frequently Asked Questions :

How is ABREVA different from the over-the-counter cold sore remedies I have already been using?

Abreva is the only FDA approved non-prescription cold sore medicine that can actually shorten healing time and the duration of symptoms. The sooner you start using ABREVA, the sooner you can begin
healing your cold sore.

Who can use ABREVA?

Adults and children 12 years and over can use ABREVA.

How often can I apply ABREVA?

ABREVA should be used five times a day until the cold sore is healed. Apply it directly to the cold sore at the first sign of a tingle, redness, bump or itch for best results.

Can I apply cosmetics on top of ABREVA?

Yes, cosmetics such as lipstick may be applied over ABREVA. However, use a separate applicator, like a cotton swab, to apply cosmetics over an unhealed cold sore to avoid spreading the infection. For best results, remove any cosmetics prior to applying ABREVA.

Herpes simplex viruses are extremely widespread. But, quite counterintuitively, they are also widely stigmatized in spite of the fact that most people are positive for HSV-1, the main cause of oral herpes. And according to the Centers for Disease Control and Prevention, over one in six people from 14 to 49 have genital herpes, which is primarily caused by HSV-2 infection. These viruses are worth talking about, and that means parsing the difference between them.

Chances are good that you know someone or are someone who deals with herpes, whether it’s present in the form of cold sores on the face or lesions around the genital region. Location of an outbreak serves as the most common difference between infection with HSV-1 and infection with HSV-2, but beyond that, many people are unclear on what sets them apart. We spoke with experts about what you need to know about symptoms, transmission, and treatment of these distinct and yet closely related infections.

Where are the two infections located within the body?

The main differentiator of the first two herpes simplex viruses is their location or where they appear, both inside and outside of the body. With HSV-`1, or oral herpes, those who experience symptoms will get what is commonly known as a cold sore or a fever blister, which occurs on or around the lips. HSV-2, on the other hand, lives as similar-looking sores or blisters in the genital region: on the vulva or penis or around the anus. (It’s worth noting the HSV-1 can also lead to genital herpes via oral sex.)

Sejal Shah, a New York City-based dermatologist and founder of Smarter Skin Dermatology, explains that these viruses often remain dormant in the nervous system, though also in different spots: “HSV-1 remains dormant in the head and neck area while HSV-2 stays near the lower part of the spine,” she says. What’s more, Shah explains that they are similar in that once an infection occurs, the virus responsible can lead to outbreaks again and again. In other words, once HSV-1 or HSV-2 is in your body, it can’t be fully cleared, even though you may never experience a visible outbreak.

How do these viruses spread?

Both HSV-1 and HSV-2 are spread through direct contact with someone infected, according to Shah, though you’re more likely to get the oral infection from oral-to-oral contact such as kissing, sharing drinks or eating utensils, or sharing toothbrushes. Genital herpes is considered a sexually transmitted infection (STI) as it is usually spread by sexual contact, including vaginal intercourse, oral sex, and anal sex. You’re more likely to become infected if your partner is having an active outbreak, such as a lesion on the genitals or a cold sore. That said, either infection can also spread when symptoms aren’t present thanks to what’s known as viral or asymptomatic shedding.

Unfortunately, we’re now seeing more cases of both viruses occurring in both areas. Joshua Zeichner, the director of cosmetic and clinical research at Mount Sinai Hospital in New York City, says this may be in part due to the prevalence of oral sex. According to Shah, however, genital herpes outbreaks caused by HSV-1 do not recur as frequently as genital herpes outbreaks due to HSV-2. As of now, there is no way to distinguish which one you have unless you do a viral culture. “We anecdotally see HSV-1 growing in the genitals and HSV-2 growing in the lip cultures sometimes,” Zeichner says.

What can potentially trigger outbreaks?

When people do experience outbreaks in the form of blisters on either the face or genitals, it’s most often after a trauma or when the immune system is compromised, Zeichner says: “It lives within the nerve and it forms a new active skin infection when the immune system is run down or after having a cold, the flu, or after a sunburn.” So, if you do know your HSV status and it’s positive (though we now know it’s incredibly difficult to tell without an active outbreak), it’s important to do what you can to keep your immune system running at 100.

OK, I get that they’re common — so why are genital herpes so stigmatized?

While people may be shamed for having either condition, there’s no denying that genital herpes is even more disparaged. Myriad factors have contributed to this stigma over the years, with people unjustly viewed as unhygienic or even immoral for contracting herpes, and negative references in movies, television, and drug advertising have worsened this problem. This is due in part to misunderstanding or lack of knowledge, but it could also be attributed to societal expectations on sex and sexuality, particularly toward people who identify as female and/or LGBTQIA+. Too many people aren’t aware of the facts, which then leads them to make false assumptions or stress over something that’s very difficult to control.

What should I know about treatment?

HSV-1 and HSV-2 can both be treated by taking antivirals daily, which will lower your risk of transmission and reduce the number of outbreaks you get. Cold sores caused by HSV-1 can also be treated with over-the-counter options such as Abreva, which is most effective when applied before sores arise. With both forms of herpes, you may experience a “prodromal” phase that lets you know an outbreak is coming. During this period, burning, itching, or tingling sensations in the affected area are common, and it’s best to start treatment at the first sign of something coming. And at the end of the day, remember that herpes is both common and nothing to be ashamed of. The important thing is that you get whatever care you need.

Read more stories about sex and sexual health:

  • 6 Things You Need to Know About Herpes Tests and Their Accuracy
  • How to Tell the Difference Between a Pimple and a Cold Sore
  • This Is the Herpes Myth You Need to Stop Believing

Now, watch our wellness editor taste do a flavored lube taste test:

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Our resident pharmacist Rita Ghelani offers her expert advice on using Zovirax cream to treat a cold sore, including info about how long to use for, how it works and possible side effects.

What is Zovirax cream?

Zovirax cream contains aciclovir 5% an antiviral.

Zovirax cold sore cream (2g tube) can be brought from pharmacies specifically to treat cold sores. Aciclovir 5% cream is also available as a generic medicine, without a brand name.

What is Zovirax cream used for?

Zovirax cream can be prescribed to treat cold sores and genital herpes, which are both caused by infection with the herpes simplex virus (HSV).

Genital herpes is usually treated with aciclovir tablets as these are more effective than using the cream.

How does Zovirax cream work?

Aciclovir works by stopping the herpes simplex virus from multiplying and infecting more cells. This brings the infection under control and helps the immune system to deal with it.

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Key info to know about using Zovirax cream

▪️ It’s suitable for adults, children and women who are pregnant or breastfeeding.

▪️ It’s most effective if you start to use it as soon as you get the first signs of cold sore developing.

▪️ Apply the cream five times a day for 5 to 10 days. Wash your hands after applying the cream to avoid spreading the infection to other areas of skin.

▪️ The most common side effects of Zovirax cream are a burning or stinging sensation after you apply the cream and mild dryness or itching of the treated area.

▪️ Zovirax cream should not be used to treat herpes infections of the eye. You will be prescribed Zovirax eye ointment if you have a herpes infection in your eye.

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How to use Zovirax cream

The cream should be applied thinly to affected area five times a day, at approximately four-hourly intervals, for five to ten days until the symptoms have cleared up. Wash your hands before and after applying the cream.

The cream is most effective if you start treatment as soon as the first signs of the infection (a tingling sensation), begin to appear, though treatment can also be started after the blisters have appeared.

Don’t apply the cream inside the mouth, vagina or eyes, as it may be irritant to these areas.

Avoid touching the sores unnecessarily, with either your hands or towels, to avoid spreading the infection.

If your symptoms haven’t cleared up after 10 days treatment with Zovirax cream you should see your doctor.

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What are the side effects of Zovirax cream?

Medicines and their possible side effects can affect people in different ways. The following are some of the side effects that may be associated with Zovirax cream. Just because a side effect is stated here doesn’t mean that all people using this cream will experience that or any side effect.

Uncommon side effects (affect between 1 in 100 and 1 in 1000 people)

  • Temporary stinging or burning sensation after applying the cream.
  • Mild drying or flaking of the skin where the cream is applied.
  • Itching at the area of application.

Rare side effects (affect between 1 in 1000 and 1 in 10,000 people)

  • Flushing of the skin.
  • Allergic inflammation of the skin (contact dermatitis).

If you want any more information about the possible side effects of Zovirax cream, read the leaflet provided with the medicine or talk to your doctor or pharmacist.

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If you think you have experienced side effects from Zovirax cream you can report them using the yellow card scheme.

Can I use Zovirax cream with other medicines?

Yes, Zovirax cream is not known to affect other medicines.

However, if you need to use other topical medicines on the same area of skin it’s best to leave at least 15 minutes between applying each product. This is to allow each product time to be absorbed and avoid them mixing or diluting on the skin.

Last updated 18.11.2019

Rita Ghelani (BPharm, MRPharmS) Pharmacist A UK registered practising pharmacist with over 20 years’ experience, Rita is a member of the medical journalists’ association (MJA) and has a wealth of experience in community pharmacy.

Abreva Cold Sore/Fever Blister Treatment .07oz


Abreva Cold Sore/Fever Blister Treatment .07oz


  • Cold Sore Treatment
  • Treats cold sores/fever blisters on the face or lips
  • Shortens healing time and duration of symptoms: Tingling, pain, burning, and/or itching
  • Cold Sore Medicine that Penetrates Deep and Starts to Work Immediately to Block the Virus
  • Over-the-counter so no prescriptions required
  • Discrete tube size
  • Dries clear, odorless and tasteless
  • 10% Docosanol ensure a powerful treatment against cold sore outbreaks
  • Quite simply, Abreva cream shortens healing time like a prescription, but without one
  • #1 Pharmacist Recommended
  • When used early, it can knock out your cold sore in 2½ days
  • Abreva cream has a unique formulation, with an active ingredient that speeds healing
  • Abreva cream penetrates deep and starts to work immediately to block the cold sore virus from entering healthy cells
  • Not all cold sore treatments are created equal; only Abreva cream penetrates deep to the source of your cold sore to heal it. No other non-prescription cold sore product can do that
  • The medicine in Abreva cream goes deep into the skin to strengthen the cell membranes surrounding your healthy skin cells
  • Abreva cream is the only non-prescription brand that has been clinically proven to shorten the healing time of cold sores and is approved by the FDA to heal cold sores

How Abreva Cream Fights Cold Sores?

Step 1
When the cold sore virus activates, it spreads from cell to cell

Step 2
As soon as you apply, Abrevagets to work. First, it penetrates into the skin

Step 3
Then, Abrevablocks the virus, protecting healthy cells

Step 4
When used at the first sign, Abrevacan heal a cold sore in 2½ days


  • Adults and children 12 years or over: wash hands before and after applying cream
  • Apply to affected area on face or lips at the first sign of cold sore/fever blister (tingle). Early treatment ensures the best results
  • Rub in gently but completely
  • Use 5 times a day until healed
  • Children under 12 years: ask a doctor


  • Active Ingredients: Docosanol 10% (Cold sore/fever blister treatment)
  • Inactive Ingredients: Benzyl Alcohol, Light Mineral Oil, Propylene Glycol, Purified Water, Sucrose Distearate, Sucrose Stearate

Customer Questions & Answers:

What does it look like?

Abreva cream comes in a convenient 2.0-gram tube so that you can easily carry it with you and apply as directed. Abreva cream is a smooth, white cream that has no smell or taste. It dries clear so that it can be your secret defense against cold sores

How is it packaged?

Abreva cream comes in a tube or pump that you can easily carry with you so at the first sign of a cold sore, you can start fighting. Abreva cream is a smooth, white cream that dries clear. It won’t sting or burn and it has no smell or taste. It can be your strongest defense and secret weapon against cold sores

How is Abreva cream different from other cold sore products?

Abreva cream is the only non-prescription cold sore medication approved by the FDA to shorten healing time and the duration of symptoms. Other non-prescription treatments like Orajel and Carmex only provide temporary relief from the symptoms of a cold sore. Abrevacream contains a unique, active ingredient that, when used at the first sign of a cold sore, helps to protect healthy cells from the cold sore infection

How long will a tube of Abreva cream last for the average cold sore sufferer? How many applications can I expect to get out of one 2.0-gram tube of Abreva cream?

It is important to apply Abreva cream according to the package directions and recommended dosage (avoid trying to “stretch” the product to last for an extra episode). Our surveys indicate that a tube of Abreva cream will last the average cold sore sufferer through 2-3 episodes (a year’s supply for the average sufferer). However, because the duration of cold sores varies among different individuals, your results may vary

When should I use Abreva cream?

For best results, start fighting with Abreva cream the moment you feel a cold sore coming on. Learn what triggers your cold sore and how to recognize the signs of a tingle, redness, bump or itch so you can start to fight as soon as you feel it. Abreva cream should be used five times a day for up to 10 days.Go hereto learn more about how to use Abreva cream

If I feel a tingle, but the cold sore hasn’t erupted yet, can I use this?

Yes. Begin using Abreva cream at the first sign of a cold sore for best results. Based on laboratory studies, Abreva cream penetrates deep and starts to work immediately to block the cold sore virus

Will this help if I start to apply it after the blister has developed?

Best results are seen when Abreva cream is used early in a cold sore episode. Once your cold sore has reached the stage of forming an ulcer or even a crust, then it may not be as effective in shortening healing time

Will the scab on my cold sore interfere with the absorption of the product? Can I peel the scabs on my cold sore?

Once the scab has formed, your cold sore is nearing its stage of complete healing. Keep applying the product for the 10 days, or until the scab has fallen off, whichever is the earliest. We do not recommend peeling the scab. You could damage the new, delicate skin underneath. Let the scab fall off naturally

What if I miss a dose?

Apply a dose as soon as you remember and then reapply the next dose on schedule

How do I use Abreva cream?

Apply five times a day until healed for up to 10 days. You can apply with a cotton swab or with your finger, but do wash hands before and after applying the cream. Use an ample amount to completely cover the sore and the area around the sore for best results. Per package directions, rub in gently, but completely. Abreva cream dries clear once rubbed in

How should I apply this? Should I use my fingertip or a cotton swab? How much should I apply each time?

You may use your fingertip or a cotton swab. Apply enough to completely cover your cold sore and follow the directions on the package. If you use your finger to apply, make sure to wash your hands before and after applying Abreva cream

Do I need to apply this product around the clock or only during waking hours? How far apart should the applications be spaced?

Apply five times a day during waking hours — approximately every 3-4 hours

How often can I reapply?

Abrevacream should be applied five times/day, until healed. Apply Abrevacream after you wash your face

Can it be used to treat genital herpes, canker sores or shingles? Can I use this on the cracks that form in the corners of my mouth?

No. Abreva cream is indicated only for the treatment of cold sores caused by Herpes Simplex Virus Type 1

How thin or thick of a coating should I apply?

Use an ample amount to completely cover your cold sore and the area around your cold sore for best results. Per package directions, rub in gently, but completely

Who can use it? Is it safe?

Abreva cream can be used by adults and children over 12 years old. Abrevacream has a well-established safety profile. Abreva cream should be used five times a day for up to 10 days. And because cold sores are contagious, you won’t want to share your tube of Abreva cream with others. Doing so may spread the infection

Can I use longer than 10 days?

No. It is not recommended for use longer than 10 days. Also, it could be the sign of a more serious infection, so you should contact your health care professional for advice

Why should I call my doctor if my cold sore has not healed in 10 days?

You should contact your doctor if your cold sore has not healed within 10 days while using Abreva cream. If your cold sore has not healed after this length of time, then getting the doctor to look at it will ensure that you receive an updated diagnosis and possibly additional treatment

Can I apply cosmetics on top of it?

Yes. Cosmetics, such as lipstick, may be applied over Abreva cream. However, use a separate applicator, like a cotton swab, to apply cosmetics or sunscreen over an unhealed cold sore to avoid spreading the infection. For best results, remove any cosmetics prior to applying/reapplying Abreva

Can I use it in conjunction with other topical products (i.e., Carmex, Blistex, etc.)?

We have not studied the use of Abrevacream with other topical cold sore products and do not know whether using lip balms or ointments will interfere with Abreva cream’s effectiveness

Can I use it if I am pregnant or breast-feeding?

Testing has not been conducted with Abreva cream on pregnant or breast-feeding women. Consult your physician

Your label warning says to get medical help if the product is swallowed. What happens if I lick my lips and swallow some of the cream? Will this harm me?

This statement is precautionary in the event that someone swallows a large amount of the tube contents. The amount ingested by licking the affected area will be minimal and should not give cause for concern. If in doubt, always ask your physician’s advice

What can I expect to happen if I get some Abrevacream on the skin around the sore?

Abrevacream is safe to apply on both normal skin and cold sores. In fact, applying Abreva cream both on and around the sore is good as it will ensure both the obvious cold sore and areas still developing are adequately treated

Why can’t I apply this inside my mouth or nose?

Mucous membranes inside the mouth and nose are very sensitive and you could experience some irritation of the membranes. If your cold sore spreads upward to involve the outside of the nostrils, then Abreva cream can be safely applied. It is not recommended that you insert Abreva cream inside the nose

What happens if I actually get some in my mouth?

Small amounts that get just inside the lip/mouth junction by the cold sore should not be a problem. However, if you accidentally place a large amount of cream into your mouth, then remove the cream, rinse out your mouth with water and contact your health professional


  • For external use only
  • Do not use if you are allergic to any ingredient in this product
  • When using this product: apply only to affected areas
  • Do not use in or near the eyes
  • Avoid applying directly inside your mouth
  • Do not share this product with anyone. This may spread infection
  • Stop use and ask a doctor if your cold sore gets worse or the cold sore is not healed within 10 days
  • Keep out of reach of children
  • If swallowed, get medical help or contact a poison control center right away
  • Do not freeze

Note: Image and Description may vary from actual product due to Continuous manufacturer Product updates. We recommend that you do not rely solely on the information presented and that you always read labels, warnings, and directions before using or consuming a product

SIDE EFFECTS: Redness or swelling may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using docosanol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: If you are using this product under your doctor’s direction, your doctor or pharmacist may already be aware of possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: This medicine may be harmful if swallowed. If swallowing or overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others. Doing so may spread the infection.Cold sore outbreaks can be caused by many factors such as stress, hormonal changes (such as pregnancy, menstrual period), injury/surgery on the mouth (such as dental work), tiredness, sunlight, cold weather, or fever/cold/flu.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C). Protect from freezing. If you have any questions about storage, ask your pharmacist. Keep all drug products away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised March 2013. Copyright(c) 2013 First Databank, Inc.


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